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Effect of drugs on bone mineral density in postmenopausal osteoporosis: a Bayesian network meta-analysis
BACKGROUND: Osteoporosis affects mostly postmenopausal women, leading to deterioration of the microarchitectural bone structure and low bone mass, with an increased fracture risk with associated disability, morbidity and mortality. This Bayesian network meta-analysis compared the effects of current...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8393477/ https://www.ncbi.nlm.nih.gov/pubmed/34452621 http://dx.doi.org/10.1186/s13018-021-02678-x |
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author | Migliorini, Filippo Maffulli, Nicola Colarossi, Giorgia Eschweiler, Jörg Tingart, Markus Betsch, Marcel |
author_facet | Migliorini, Filippo Maffulli, Nicola Colarossi, Giorgia Eschweiler, Jörg Tingart, Markus Betsch, Marcel |
author_sort | Migliorini, Filippo |
collection | PubMed |
description | BACKGROUND: Osteoporosis affects mostly postmenopausal women, leading to deterioration of the microarchitectural bone structure and low bone mass, with an increased fracture risk with associated disability, morbidity and mortality. This Bayesian network meta-analysis compared the effects of current anti-osteoporosis drugs on bone mineral density. METHODS: The present systematic review and network meta-analysis follows the PRISMA extension statement to report systematic reviews incorporating network meta-analyses of health care interventions. The literature search was performed in June 2021. All randomised clinical trials that have investigated the effects of two or more drug treatments on BMD for postmenopausal osteoporosis were accessed. The network comparisons were performed through the STATA Software/MP routine for Bayesian hierarchical random-effects model analysis. The inverse variance method with standardised mean difference (SMD) was used for analysis. RESULTS: Data from 64 RCTs involving 82,732 patients were retrieved. The mean follow-up was 29.7 ± 19.6 months. Denosumab resulted in a higher spine BMD (SMD −0.220; SE 3.379), followed by pamidronate (SMD −5.662; SE 2.635) and zoledronate (SMD −10.701; SE 2.871). Denosumab resulted in a higher hip BMD (SMD −0.256; SE 3.184), followed by alendronate (SMD −17.032; SE 3.191) and ibandronate (SMD −17.250; SE 2.264). Denosumab resulted in a higher femur BMD (SMD 0.097; SE 2.091), followed by alendronate (SMD −16.030; SE 1.702) and ibandronate (SMD −17.000; SE 1.679). CONCLUSION: Denosumab results in higher spine BMD in selected women with postmenopausal osteoporosis. Denosumab had the highest influence on hip and femur BMD. LEVEL OF EVIDENCE: Level I, Bayesian network meta-analysis of RCTs |
format | Online Article Text |
id | pubmed-8393477 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-83934772021-08-30 Effect of drugs on bone mineral density in postmenopausal osteoporosis: a Bayesian network meta-analysis Migliorini, Filippo Maffulli, Nicola Colarossi, Giorgia Eschweiler, Jörg Tingart, Markus Betsch, Marcel J Orthop Surg Res Systematic Review BACKGROUND: Osteoporosis affects mostly postmenopausal women, leading to deterioration of the microarchitectural bone structure and low bone mass, with an increased fracture risk with associated disability, morbidity and mortality. This Bayesian network meta-analysis compared the effects of current anti-osteoporosis drugs on bone mineral density. METHODS: The present systematic review and network meta-analysis follows the PRISMA extension statement to report systematic reviews incorporating network meta-analyses of health care interventions. The literature search was performed in June 2021. All randomised clinical trials that have investigated the effects of two or more drug treatments on BMD for postmenopausal osteoporosis were accessed. The network comparisons were performed through the STATA Software/MP routine for Bayesian hierarchical random-effects model analysis. The inverse variance method with standardised mean difference (SMD) was used for analysis. RESULTS: Data from 64 RCTs involving 82,732 patients were retrieved. The mean follow-up was 29.7 ± 19.6 months. Denosumab resulted in a higher spine BMD (SMD −0.220; SE 3.379), followed by pamidronate (SMD −5.662; SE 2.635) and zoledronate (SMD −10.701; SE 2.871). Denosumab resulted in a higher hip BMD (SMD −0.256; SE 3.184), followed by alendronate (SMD −17.032; SE 3.191) and ibandronate (SMD −17.250; SE 2.264). Denosumab resulted in a higher femur BMD (SMD 0.097; SE 2.091), followed by alendronate (SMD −16.030; SE 1.702) and ibandronate (SMD −17.000; SE 1.679). CONCLUSION: Denosumab results in higher spine BMD in selected women with postmenopausal osteoporosis. Denosumab had the highest influence on hip and femur BMD. LEVEL OF EVIDENCE: Level I, Bayesian network meta-analysis of RCTs BioMed Central 2021-08-27 /pmc/articles/PMC8393477/ /pubmed/34452621 http://dx.doi.org/10.1186/s13018-021-02678-x Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Systematic Review Migliorini, Filippo Maffulli, Nicola Colarossi, Giorgia Eschweiler, Jörg Tingart, Markus Betsch, Marcel Effect of drugs on bone mineral density in postmenopausal osteoporosis: a Bayesian network meta-analysis |
title | Effect of drugs on bone mineral density in postmenopausal osteoporosis: a Bayesian network meta-analysis |
title_full | Effect of drugs on bone mineral density in postmenopausal osteoporosis: a Bayesian network meta-analysis |
title_fullStr | Effect of drugs on bone mineral density in postmenopausal osteoporosis: a Bayesian network meta-analysis |
title_full_unstemmed | Effect of drugs on bone mineral density in postmenopausal osteoporosis: a Bayesian network meta-analysis |
title_short | Effect of drugs on bone mineral density in postmenopausal osteoporosis: a Bayesian network meta-analysis |
title_sort | effect of drugs on bone mineral density in postmenopausal osteoporosis: a bayesian network meta-analysis |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8393477/ https://www.ncbi.nlm.nih.gov/pubmed/34452621 http://dx.doi.org/10.1186/s13018-021-02678-x |
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